NCLEX NGN RN ACTUAL EXAM LATEST MAY 2023
TEST BANK 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES AGRADE
A nurse assesses an oral temperature for an adult patient. The patient's temperature is
37.5°C (99.5°F). What term would the nurse use to report this temperature?
a. Febrile
b. Hypothermia
c. Hypertension
d. Afebrile - ANSWER>>d. Afebrile means without fever. This temperature is within the
normal range for an adult. Fever (pyrexia) is an elevation of body temperature; a person
with fever is said to be febrile. Hypothermia is a low body temperature and hyperthermia
is a high body temperature.
A nurse administers a dose of an oral medication for hypertension to a patient who
immediately vomits after swallowing the pill. What would be the appropriate initial action
of the nurse in this situation?
a. Readminister the medication and notify the primary care provider.
b. Readminister the pill in a liquid form if possible.
c. Assess the vomit, looking for the pill.
d. Notify the primary care provider. - ANSWER>>c. If a patient vomits immediately after
swallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it.
The nurse should then notify the primary care provider to see if another dosage should
be administered.
A nurse is administering an oral medication to a patient via a gastric tube. The nurse
observes the medication enter the tube, and then the tube becomes clogged. What
would be the appropriate initial action of the nurse in this situation?
a. Attempt to dislodge the medication with a 10-mL syringe.
b. Notify the primary care provider.
c. Remove the tube and replace it with another tube.
d. Flush the tube with 60 mL of water. - ANSWER>>a. If medication becomes clogged
in a gastric tube, the nurse should attach a 10-mL syringe on the end of the tube and
pull back and lightly apply pressure to the plunger in a repetitive motion to attempt to
dislodge the medication. If the medication does not move through the tube, the nurse
should notify the primary care provider, who may request the tube be replaced.
A nurse who is administering medications to patients in an acute care setting studies
the pharmacokinetics of the drugs being administered. Which statements accurately
describe these mechanisms of action? Select all that apply.
a. Distribution occurs after a drug has been absorbed into the bloodstream and is made
available to body fluids and tissues.
,b. Metabolism is the process by which a drug is transferred from its site of entry into the
body to the bloodstream.
c. Absorption is the change of a drug from its original form to a new form, usually
occurring in the liver.
d. During first-pass effect, drugs move from the intestinal lumen to the liver by way of
the portal vein instead of going into the system's circulation.
e. The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are
routes of drug absorption.
f. Excretion is the process of removing a drug, or its metabolites (products of metabolis -
ANSWER>>a, d, f. Distribution occurs after a drug has been absorbed into the
bloodstream and the drug is distributed throughout the body, becoming available to
body fluids and body tissues. Some drugs move from the intestinal lumen to the liver by
way of the portal vein and do not go directly into the systemic circulation following oral
absorption. This is called the first-pass effect, or hepatic first pass. Excretion is the
process of removing a drug or its metabolites (products of metabolism) from the body.
Absorption is the process by which a drug is transferred from its site of entry into the
body to the bloodstream. Metabolism, or biotransformation, is the change of a drug from
its original form to a new form. The liver is the primary site for drug metabolism. The
gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of
drug excretion.
A nurse is reconstituting powdered medication in a vial. Which action is a recommended
step in this process?
a. The nurse draws up the proper amount of powered medication into the syringe.
b. The nurse inserts the needle through the rubber stopper of the diluent vial.
c. The nurse gently agitates the powdered medication vial to mix the powder and diluent
completely.
d. The nurse draws up the prescribed amount of medication while holding the syringe
horizontally at eye level. - ANSWER>>c. When reconstituting powdered medication in a
vial, the nurse should draw up the appropriate amount of diluent into the syringe, insert
the needle through the center of the self-sealing stopper on the powdered medication
vial, inject the diluent into the powdered medication vial, remove the needle from the vial
and replace the cap, and gently agitate the vial to mix the powdered medication and
diluent completely. The nurse should then draw up the prescribed amount of medication
while holding the syringe vertically and at eye level.
A medication order reads: "K-Dur, 20 mEq po b.i.d." When and how does the nurse
correctly give this drug?
a. Daily at bedtime by subcutaneous route
b. Every other day by mouth
c. Twice a day by the oral route
d. Once a week by transdermal patch - ANSWER>>c. The abbreviation "b.i.d." refers to
twice-a-day administration. po (by mouth) refers to administration by the oral route.
, A nurse is preparing medications for patients in the ICU. The nurse is aware that there
are patient variables that may affect the absorption of these medications. Which
statements accurately describe these variables? Select all that apply.
a. Patients in certain ethnic groups obtain therapeutic responses at lower doses or
higher doses than those usually prescribed.
b. Some people experience the same response with a placebo as with the active drug
used in studies.
c. People with liver disease metabolize drugs more quickly than people with normal liver
functioning.
d. A patient who receives a pain medication in a noisy environment may not receive full
benefit from the medication's effects.
e. Oral medications should not be given with food as the food may delay the absorption
of the medications.
f. Circadian rhythms and cycles may influence drug action. - ANSWER>>a, b, d, f.
Nurses need to know about medications that may produce varied responses in patients
from different ethnic groups. The patient's expectations of the medication may affect the
response to the medication, for example, when a placebo is given and a patient has a
therapeutic effect. The patient's environment may also influence the patient's response
to medications, for example, sensory deprivation and overload may affect drug
responses. Circadian rhythms and cycles may also influence drug action. The liver is
the primary organ for drug breakdown, thus pathologic conditions that involve the liver
may slow metabolism and alter the dosage of the drug needed to reach a therapeutic
level. The presence of food in the stomach can delay the absorption of orally
administered medications. Alternately, some medications should be given with food to
prevent gastric irritation, and the nurse should consider this when establishing a
patient's medication schedule. Other medications may have enhanced absorption if
taken with certain foods.
A physician orders a pain medication for a postoperative patient that is a PRN order.
When would the nurse administer this medication?
a. A single dose during the postoperative period
b. Doses administered as needed for pain relief
c. One dose administered immediately
d. Doses routinely administered as a standing order - ANSWER>>b. When the
prescriber writes a PRN order ("as needed") for medication, the patient receives
medication when it is requested or required. With a single or one-time order, the
directive is carried out only once, at a time specified by the prescriber. A stat order is a
single order carried out immediately. A standing order (or routine order) is carried out as
specified until it is canceled by another order.
A nurse is administering a pain medication to a patient. In addition to checking his
identification bracelet, the nurse correctly verifies his identity by:
a. Asking the patient his name
b. Reading the patient's name on the sign over the bed
c. Asking the patient's roommate to verify his name
TEST BANK 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES AGRADE
A nurse assesses an oral temperature for an adult patient. The patient's temperature is
37.5°C (99.5°F). What term would the nurse use to report this temperature?
a. Febrile
b. Hypothermia
c. Hypertension
d. Afebrile - ANSWER>>d. Afebrile means without fever. This temperature is within the
normal range for an adult. Fever (pyrexia) is an elevation of body temperature; a person
with fever is said to be febrile. Hypothermia is a low body temperature and hyperthermia
is a high body temperature.
A nurse administers a dose of an oral medication for hypertension to a patient who
immediately vomits after swallowing the pill. What would be the appropriate initial action
of the nurse in this situation?
a. Readminister the medication and notify the primary care provider.
b. Readminister the pill in a liquid form if possible.
c. Assess the vomit, looking for the pill.
d. Notify the primary care provider. - ANSWER>>c. If a patient vomits immediately after
swallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it.
The nurse should then notify the primary care provider to see if another dosage should
be administered.
A nurse is administering an oral medication to a patient via a gastric tube. The nurse
observes the medication enter the tube, and then the tube becomes clogged. What
would be the appropriate initial action of the nurse in this situation?
a. Attempt to dislodge the medication with a 10-mL syringe.
b. Notify the primary care provider.
c. Remove the tube and replace it with another tube.
d. Flush the tube with 60 mL of water. - ANSWER>>a. If medication becomes clogged
in a gastric tube, the nurse should attach a 10-mL syringe on the end of the tube and
pull back and lightly apply pressure to the plunger in a repetitive motion to attempt to
dislodge the medication. If the medication does not move through the tube, the nurse
should notify the primary care provider, who may request the tube be replaced.
A nurse who is administering medications to patients in an acute care setting studies
the pharmacokinetics of the drugs being administered. Which statements accurately
describe these mechanisms of action? Select all that apply.
a. Distribution occurs after a drug has been absorbed into the bloodstream and is made
available to body fluids and tissues.
,b. Metabolism is the process by which a drug is transferred from its site of entry into the
body to the bloodstream.
c. Absorption is the change of a drug from its original form to a new form, usually
occurring in the liver.
d. During first-pass effect, drugs move from the intestinal lumen to the liver by way of
the portal vein instead of going into the system's circulation.
e. The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are
routes of drug absorption.
f. Excretion is the process of removing a drug, or its metabolites (products of metabolis -
ANSWER>>a, d, f. Distribution occurs after a drug has been absorbed into the
bloodstream and the drug is distributed throughout the body, becoming available to
body fluids and body tissues. Some drugs move from the intestinal lumen to the liver by
way of the portal vein and do not go directly into the systemic circulation following oral
absorption. This is called the first-pass effect, or hepatic first pass. Excretion is the
process of removing a drug or its metabolites (products of metabolism) from the body.
Absorption is the process by which a drug is transferred from its site of entry into the
body to the bloodstream. Metabolism, or biotransformation, is the change of a drug from
its original form to a new form. The liver is the primary site for drug metabolism. The
gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of
drug excretion.
A nurse is reconstituting powdered medication in a vial. Which action is a recommended
step in this process?
a. The nurse draws up the proper amount of powered medication into the syringe.
b. The nurse inserts the needle through the rubber stopper of the diluent vial.
c. The nurse gently agitates the powdered medication vial to mix the powder and diluent
completely.
d. The nurse draws up the prescribed amount of medication while holding the syringe
horizontally at eye level. - ANSWER>>c. When reconstituting powdered medication in a
vial, the nurse should draw up the appropriate amount of diluent into the syringe, insert
the needle through the center of the self-sealing stopper on the powdered medication
vial, inject the diluent into the powdered medication vial, remove the needle from the vial
and replace the cap, and gently agitate the vial to mix the powdered medication and
diluent completely. The nurse should then draw up the prescribed amount of medication
while holding the syringe vertically and at eye level.
A medication order reads: "K-Dur, 20 mEq po b.i.d." When and how does the nurse
correctly give this drug?
a. Daily at bedtime by subcutaneous route
b. Every other day by mouth
c. Twice a day by the oral route
d. Once a week by transdermal patch - ANSWER>>c. The abbreviation "b.i.d." refers to
twice-a-day administration. po (by mouth) refers to administration by the oral route.
, A nurse is preparing medications for patients in the ICU. The nurse is aware that there
are patient variables that may affect the absorption of these medications. Which
statements accurately describe these variables? Select all that apply.
a. Patients in certain ethnic groups obtain therapeutic responses at lower doses or
higher doses than those usually prescribed.
b. Some people experience the same response with a placebo as with the active drug
used in studies.
c. People with liver disease metabolize drugs more quickly than people with normal liver
functioning.
d. A patient who receives a pain medication in a noisy environment may not receive full
benefit from the medication's effects.
e. Oral medications should not be given with food as the food may delay the absorption
of the medications.
f. Circadian rhythms and cycles may influence drug action. - ANSWER>>a, b, d, f.
Nurses need to know about medications that may produce varied responses in patients
from different ethnic groups. The patient's expectations of the medication may affect the
response to the medication, for example, when a placebo is given and a patient has a
therapeutic effect. The patient's environment may also influence the patient's response
to medications, for example, sensory deprivation and overload may affect drug
responses. Circadian rhythms and cycles may also influence drug action. The liver is
the primary organ for drug breakdown, thus pathologic conditions that involve the liver
may slow metabolism and alter the dosage of the drug needed to reach a therapeutic
level. The presence of food in the stomach can delay the absorption of orally
administered medications. Alternately, some medications should be given with food to
prevent gastric irritation, and the nurse should consider this when establishing a
patient's medication schedule. Other medications may have enhanced absorption if
taken with certain foods.
A physician orders a pain medication for a postoperative patient that is a PRN order.
When would the nurse administer this medication?
a. A single dose during the postoperative period
b. Doses administered as needed for pain relief
c. One dose administered immediately
d. Doses routinely administered as a standing order - ANSWER>>b. When the
prescriber writes a PRN order ("as needed") for medication, the patient receives
medication when it is requested or required. With a single or one-time order, the
directive is carried out only once, at a time specified by the prescriber. A stat order is a
single order carried out immediately. A standing order (or routine order) is carried out as
specified until it is canceled by another order.
A nurse is administering a pain medication to a patient. In addition to checking his
identification bracelet, the nurse correctly verifies his identity by:
a. Asking the patient his name
b. Reading the patient's name on the sign over the bed
c. Asking the patient's roommate to verify his name
